Name change may end paternalism

Hannibal Lecter, the psychiatrist in The Silence of the Lambs,
consumed people. For too long service users have been consumed by
services. They are labelled as service users to serve the interests
of professionals rather than being encouraged to choose their own

In the beginning, people who used services had no choice but to
accept being labelled as service users. Over time the term became
anodyne with service users being led to believe they had a choice.

At the social services day centre I attend, we have decided to call
ourselves “consumerees” – comparable in to the term employees.
However, bringing about a change in terminology is proving

We decided to call ourselves consumerees as a result of a
democratic vote. Some staff members opposed our decision and seemed
to disrespect our right to be identified by a name of our own
choosing. It was even suggested that the term consumerees was too
complicated because of its number of syllables.

Discussion around the appropriate terms to describe people who
receive services has largely been confined to “clients” and
“consumers”. These terms, stemming from professionally led
services, have always smacked of paternalism, hence the opposition
when we decided to choose our own label without consulting “them”.

Those of us who receive services because of mental illness are
aware of the many times when we are treated as children, and feel
that advantage is taken at times when we are unable to challenge.
From experience we suspect that any term chosen is likely to be
turned into something else by the professionals.

Being a consumeree means being aware that it is us who provide jobs
for the professionals and it is us who ensure they have an adequate
income. It is us who significantly contribute to their training and
it is us who provide the data that enables them to complete
successful research. Consumerees do all this and we don’t get paid
for our contributions except on rare occasions.

By deciding a name for ourselves we liberate ourselves. Consumerees
dismiss claims that we are being empowered – instead we resist
attempts to disempower us from the start. And consumerees are not
afraid of jargon, but ask and challenge when appropriate.

In my view, professionals are not doing us a favour. We are doing
them a favour by allowing them the privilege of caring for
vulnerable people and being paid at the same time for an enriching

Michael Elvin is a mental health activist.

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